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Articles 4261 - 4290 of 5875
Full-Text Articles in Medicine and Health Sciences
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Walden Dissertations and Doctoral Studies
Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …
Lived Experiences Of The Individual Mandate Of The Affordable Care Act, Wendy Berry
Lived Experiences Of The Individual Mandate Of The Affordable Care Act, Wendy Berry
Walden Dissertations and Doctoral Studies
In 2014, the individual mandate of the Affordable Care Act (ACA) came into effect. More than 7 million Americans paid a tax penalty for not carrying insurance during the previous tax year. Millions of others were forced to purchase a health insurance plan to avoid that penalty. This study filled a gap in public health policy research by incorporating qualitative data to offer narratives along with statistical data that could help explain health outcomes to make successful policy changes in 2019. The purpose of this study was to research the use of market competitive theory by learning people's lived experiences …
Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors
Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors
Walden Dissertations and Doctoral Studies
The Hispanic population has a higher incidence of diabetes and poorer health outcomes compared to other populations in the United States. Although previous research has reported that cultural and ethnic beliefs play a role in poorer diabetes self-management by Hispanic individuals, limited studies have been focused on the barriers to self-management from the perspectives of Hispanic immigrants. The purpose of this qualitative study was to gain an understanding, through oral history narrative, of the experiences of Hispanic immigrants living with diabetes. In this study, the influence of cultural and ethnic beliefs on diabetes self-management in Hispanic immigrants in the Bronx …
Exploring Relationships Of Meaning, Co-Occurring Diagnoses, And Attitudes About Substances, Misty Grant
Exploring Relationships Of Meaning, Co-Occurring Diagnoses, And Attitudes About Substances, Misty Grant
Walden Dissertations and Doctoral Studies
It is increasingly important to understand the factors associated with individuals struggling with addiction and their quality of life, especially with those struggling with co-occurring diagnoses (CODs). The purpose of this study was to explore the extent to which meaning, and CODs of anxiety and depression predict an individual's attitudes and beliefs about addiction among persons receiving treatment for substance use disorders (SUDs). The theoretical foundation used to guide this study was logotherapy, which emphasizes the importance of increasing meaning in life through choices, while also centering on being able to find meaning in all situations. A cross-sectional correlation design …
Strategies For Shipping Temperature-Sensitive Medical Devices Using Cognitive Mapping, Eric C. Guynes
Strategies For Shipping Temperature-Sensitive Medical Devices Using Cognitive Mapping, Eric C. Guynes
Walden Dissertations and Doctoral Studies
Supply chain management (SCM) practitioners who ship temperature-sensitive diagnostic medical devices (DMDs) to clinicians must use effective cold chain management (CCM) strategies to avoid temperature excursions that contribute to medical device errors. Such errors have caused patient harm and death, which costs the U.S. health care system billions of dollars per year. The purpose of this qualitative multiple case study was to explore strategies for selecting and managing cold chain shipping solutions (CCSSs) requiring SCM executives to trade cost for regulatory compliance and predictability when mitigating temperature variations that occur during shipping. The conceptual framework for the study was the …
Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus
Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus
Walden Dissertations and Doctoral Studies
Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …
Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze
Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze
Walden Dissertations and Doctoral Studies
This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer …
Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart
Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart
Walden Dissertations and Doctoral Studies
Accountable care units (ACU-?¢) provide a new model for integrated patient care. The ACU-?¢ promotes patient centeredness in nursing units as team members work collaboratively with physicians to improve patient outcomes and reduce unwarranted variations. A health system in the southeastern United States incorporated the ACU-?¢ as part of their care model. These units were held accountable for their clinical, service, and cost outcomes but lacked a validation process to demonstrate the effective utilization of their data. The purpose of this DNP project was to create a patient centered care (PCC) certification process, guided by the Donabedian model, that would …
Advanced Practice Nurse Intervention And Heart Failure Readmissions, Tanesha Kemble
Advanced Practice Nurse Intervention And Heart Failure Readmissions, Tanesha Kemble
Walden Dissertations and Doctoral Studies
Heart failure (HF) is one of the main reasons for hospitalizations and readmissions. A local hospital collaborated with a skilled nursing facility (SNF) in 2012 with the goal of reducing systolic HF readmissions. This collaboration consisted of having an Advanced Practice Nurse (APN) who specializes in cardiac care follow up with all patients discharged from the hospital to the SNF with a diagnosis of systolic HF. The practice-focused question for this project addressed whether early follow-up and continuity of care by a cardiac APN would decrease hospital readmission within 30 days in patients with systolic HF who are discharged to …
A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque
A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque
Walden Dissertations and Doctoral Studies
Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …
Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings
Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings
Walden Dissertations and Doctoral Studies
In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …
Perceptions Of Private Medical Practitioners Towards The Nigerian National Tuberculosis Treatment Guidelines, Chijioke Pius Osakwe
Perceptions Of Private Medical Practitioners Towards The Nigerian National Tuberculosis Treatment Guidelines, Chijioke Pius Osakwe
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) is a major public health problem in many parts of the world. Nigeria is one of the 30 countries in the world that has the highest burden of TB. Private medical practitioners in Nigeria play an important role in health care delivery. Motivating them to adhere to TB treatment guidelines in managing persons suspected of having TB or diagnosed with the disease is one of the strategies employed by the National Tuberculosis Program to Reduce the Burden of TB. Few studies were identified which used qualitative study approaches to study the perceptions of these practitioners towards the TB …
Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel
Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel
Walden Dissertations and Doctoral Studies
In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this …
Hospital Executive Succession Planning Strategies, Janet Tingling
Hospital Executive Succession Planning Strategies, Janet Tingling
Walden Dissertations and Doctoral Studies
Approximately 50% of New York City hospitals lack succession planning as baby boomers transition out of the workforce into retirement. The potential loss of knowledge capital could affect leadership development and corporate stability. Guided by the transformational leadership theory, the purpose of this single site case study was to explore successful strategies executive-level leaders used to facilitate succession planning within their hospital. Three hospital executive-level leaders from a single site location participated in a semistructured face-to-face interview and provided data that assisted the analysis. Four themes emerged from the data analysis through a word cloud format that showed the most …
Workplace Bullying From A Nurses Perspective, Dawn Reid White
Workplace Bullying From A Nurses Perspective, Dawn Reid White
Walden Dissertations and Doctoral Studies
Bullying has long been associated with school children. In recent years, however, more attention has been paid to the bullying that has reached beyond the playground and into the workforce. One population facing this problem is staff nurses. To date, no one has found an effective way to address workplace bullying in the healthcare field, nor have effective methods been found for retaining trained nurses affected by this problem. The focus of this dissertation was on understanding nurses' lived experiences and how nurses decided to remain in their current working position despite these problems. Taking a phenomenological approach and using …
Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan
Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan
Walden Dissertations and Doctoral Studies
Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …
Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney
Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney
Walden Dissertations and Doctoral Studies
As the healthcare industry continues to change, dental providers are concerned about the different types of adverse events that can occur if systemic diseases are not well understood when treating patients. The purpose of this study was to explore the level of understanding among dental care providers of the relationship between oral care and systemic diseases and how these are linked to adverse events. The theoretical foundation that was used for this study was the Swiss cheese model. The research questions were designed to address the level of understanding among dental care providers of the link between oral care and …
Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton
Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton
Walden Dissertations and Doctoral Studies
The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants …
The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun
The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun
Walden Dissertations and Doctoral Studies
Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients …
Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint
Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint
Walden Dissertations and Doctoral Studies
Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …
Using Calcaneal Heel Ultrasounds To Screen For Osteoporosis At Alaska Health Fairs, Heather Guess
Using Calcaneal Heel Ultrasounds To Screen For Osteoporosis At Alaska Health Fairs, Heather Guess
Walden Dissertations and Doctoral Studies
Osteoporosis is a major health problem. The Alaska Department of Health and Social Services reports national rates of osteoporosis at 13-18% of women and 3-6% of men over age 50, but current evidence suggests that osteoporosis rates in Alaska are more equal between sexes. Known risk factors for osteoporosis that are very common among Alaskans include arthritis and low vitamin D and calcium levels. The U.S. Preventive Services Task Force (USPSTF) recommends dual-energy x-ray absorptiometry (DXA) scans of the hip and lumbar spine as the gold standard of screening for osteoporosis; however, DXA scans are expensive, not portable, and not …
A Nursing In-Service For Diabetes Education, Heidi Steiner
A Nursing In-Service For Diabetes Education, Heidi Steiner
Walden Dissertations and Doctoral Studies
Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes …
Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte
Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte
Walden Dissertations and Doctoral Studies
The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …
Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner
Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner
Walden Dissertations and Doctoral Studies
The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …
Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu
Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu
Walden Dissertations and Doctoral Studies
A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses …
Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga
Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga
Walden Dissertations and Doctoral Studies
The delivery of quality care has been a priority for the health care industry in the United States. Researchers have established positive correlations between the levels of emotional intelligence of registered nurses and their clinical performances. However, new evidence suggests the need to enhance the use of emotional intelligence (EI) in high-risk clinical units. With the intent to understand the use of EI, a phenomenological research approach was used to identify the emergency room nurse's understanding of EI. The Four-branch Model of Emotional Intelligence was used as the theoretical framework, while the research question identified the emergency room nurse's perception …
Sexism, Just-World Beliefs, And Defensive Attribution: Relationship To Online Discourse And Child Sexual Abuse, Andrea M. Barbis
Sexism, Just-World Beliefs, And Defensive Attribution: Relationship To Online Discourse And Child Sexual Abuse, Andrea M. Barbis
Walden Dissertations and Doctoral Studies
Research has shown that individuals' willingness to believe a disclosure of childhood sexual abuse (CSA) is related to just-world beliefs, ambivalent sexism, and defensive attribution. However, researchers do not know whether these variables relate to posts made in response to online articles describing CSA. Negative or disbelieving posts may impact not only the author, but also readers who view these comments via hindrance of disclosures, increased self-blame, and avoidance of help seeking. In this quantitative study, just-world, ambivalent sexism, and defensive attribution theories provided the theoretical basis used to determine whether just-world beliefs, ambivalent sexism, and defensive attribution influenced comments …
Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha
Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha
Walden Dissertations and Doctoral Studies
Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …
Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme
Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme
Walden Dissertations and Doctoral Studies
Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefited much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals' performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome …
Holistic Health And Hawaii's Renewable Energy Future, Richard M. Esterle
Holistic Health And Hawaii's Renewable Energy Future, Richard M. Esterle
Walden Dissertations and Doctoral Studies
Collective efficacy, time urgency, and health literacy have been a focus of research since the 1970s. Researchers have demonstrated that these factors influence health and decision making. However, researchers have yet to establish how these factors may be connected to the achievement of policy aims that impact holistic or environmental health. This study utilized the health belief model, social cognitive theory, time urgency theory, health education and promotion theory, Bronfenbrenner's ecological systems theory, and the Meikirch model. The purpose of this quantitative study was to determine if the factors of collective efficacy, perceived time urgency, perceived health literacy, ethnicity, age, …